Healthcare Provider Details

I. General information

NPI: 1003751066
Provider Name (Legal Business Name): COURAGEOUS HOMES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2026
Last Update Date: 04/23/2026
Certification Date: 04/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19580 W INDIAN SCHOOL RD
BUCKEYE AZ
85396-2081
US

IV. Provider business mailing address

19580 W INDIAN SCHOOL RD
BUCKEYE AZ
85396-2081
US

V. Phone/Fax

Practice location:
  • Phone: 216-906-3032
  • Fax:
Mailing address:
  • Phone: 216-906-3032
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: CHERRELL GLENN
Title or Position: CEO
Credential: LPN
Phone: 216-906-3032